ALEXANDER NISSEN (NPI# 1730540386) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730540386 |
| Entity Type | Individual |
| Full Name | ALEXANDER NISSEN |
| Practice Address |
2200 Bergquist Drive Suite 1 Whmc / Ge-2200 Jbsa Lackland Afb TX 78236-5300 |
| Practice Telephone | 2109160439 |
| Mailing Telephone | 2109160439 |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2017-11-20 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 0101263081 | VA | Allopathic & Osteopathic Physicians |
| Street Address |
2200 BERGQUIST DRIVE SUITE 1 WHMC / GE-2200 |
| City | JBSA LACKLAND AFB |
| State | TX |
| Zip Code | 78236-5300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063047363 | Arnoldo Arturo Gonzalez Jr. | Specialist/Technologist | 1033 Truemper St, Lackland Afb, TX 78236 | 2020-03-06 |
| 1023643343 | Meredith Grace Cockerell | Specialist/Technologist | W Military Drive, San Antonio, TX 78236 | 2020-03-06 |
| 1578120598 | Hali Rashelle Hall | Dentist | 1615 Truemper St, Blg 6418, Attn: 59ds/sgdn, Jbsa Lackland, TX 78236 | 2019-05-24 |
| 1952967077 | Paul Fianza Boseman | Nurse Practitioner | 1106 Wilford Hall Loop, San Antonio, TX 78236 | 2019-05-14 |
| 1689161978 | Kelly Jones Buckshire | Dentist | Dunn Dental Clinic, 1615 Truemper Rd, San Antonio, TX 78236 | 2018-04-23 |
| 1902308570 | Roger Louis Farney | Student in an Organized Health Care Education/Training Program | 1100 Wilford Hall Loop Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-28 |
| 1568916856 | Thomas Maxwell Woolf | Dentist | 1100 Wilford Hall Ambulatory Surgical Center, Lackland Afb, TX 78236 | 2016-08-04 |
| 1831544956 | Michael Veronneau | Student in an Organized Health Care Education/Training Program | 59 Mdw/ge 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland, TX 78236 | 2016-04-26 |
| 1376906958 | David Kephart Jr. | General Practice | 1100 Wilford Hall Loop Bldg 4454, Jbsa Lackland, TX 78236 | 2016-04-01 |
| 1184084089 | Olivia Arballo | Dermatology | Wilford Hall Asc, Attn: Dept of Dermatology, 1100 Wilford Hall Loop Bldg 4554, Jbsa-lackland, TX 78236 | 2016-03-04 |
| Find all providers in zip 78236 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396249744 | Michael Jay Yoo | General Practice | Whmc/ge-2200, 2200 Bergquist Dr Ste 1, Jbsa Lackland Afb, TX 78236-5300 | 2018-03-21 |
| 1740522515 | Whitney L. Pollard | General Practice | 59 Mdsp/sgomd-2200 Bergquist Drive, Suite 1, Jbsa Lackland Afb, TX 78236-9908 | 2013-03-20 |
| 1518524040 | Thomas Scheide | General Practice | Wilford Hall Ambulatory Surgical Center, 1100 Wilford Hall Loop, Bldg 4554, Jbsa Lackland Afb, TX 78236-5300 | 2019-05-21 |
| 1598266017 | Iulian Dragusin | General Practice | 1100 Wilford Hall Loop, Bldg. 4554, Jbsa Lackland Afb, TX 78236 | 2018-02-21 |
| 1427582881 | Scott Wambolt | General Practice | 2200 Bergquist Dr Ste 1, Whmc/ge-2200, Jbsa Lackland Afb, TX 78236-5300 | 2017-04-12 |
| 1033642962 | Kimpreet Kaur | General Practice | 2200 Bergquist Dr, Ste 1, Jbsa Lackland Afb, TX 78324-9907 | 2017-04-07 |
| 1861930208 | Ashley Werbin | General Practice | 1100 Wilford Hall Loop Building 4554, Jbsa Lackland Afb, TX 78236 | 2017-02-06 |
| 1871956086 | Matthew Ward | General Practice | 1100 Wilford Hall Loop, Bldg 4554, Jbsa Lackland Afb, TX 78234-9908 | 2016-04-04 |
| 1760845408 | Patrick Coleman | General Practice | 2200 Bergquist Dr Ste 1, Whmc/ge-2200, Jbsa Lackland Afb, TX 78236-5300 | 2016-03-31 |
| 1891155628 | Howard Gill Iv | General Practice | 1100 Wilford Hall Loop Bldg 4554, Jbsa Lackland Afb, TX 78236-9908 | 2016-03-07 |
| Find all providers in JBSA LACKLAND AFB | ||||
| City | JBSA LACKLAND AFB |
| Zip Code | 78236 |
Please comment or provide details below to improve the information on ALEXANDER NISSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.